Courtney Marie Jackson, MD
Family Medicine in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1013533926
StatusActive
Last updated in NPPESFeb 2, 2026
Details
- NPI
- 1013533926
- Entity type
- Individual (NPI-1)
- Name
- Courtney Marie Jackson
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 17, 2020
- Certification date
- Feb 2, 2026
- Last updated
- Feb 2, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 01088399A | IN | Yes |
Practice location
6507 E State BlvdFort Wayne, IN 46815-7026
Phone 260-486-3300 · Fax 260-485-3600
Mailing address
11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701
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